# ADVOCATE HEALTH AND HOPSITALS CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CHRIST HOSPITAL OUTPATIENT PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114063724
- **Authorized official:** MARY ANNE HICKMAN PHARM D (PHARMACY SUPERVISOR)
- **Authorized official phone:** (708) 684-5275

## Contact information

- **Practice address:** 4400 W 95TH ST STE 101, DEPARTMENT OF PHARMACY, OAK LAWN, IL 60453-2655
- **Practice address phone:** (708) 684-5275
- **Practice address fax:** (708) 684-1712
- **Mailing address:** 4400 W 95TH ST STE 101, DEPARTMENT OF PHARMACY, OAK LAWN, IL 60453-2655
- **Mailing address phone:** (708) 684-5275
- **Mailing address fax:** (708) 684-1712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054008972 | IL | Yes |

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 12/05/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1431698 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |